Преуролитиаз: состояние местных факторов литогенеза и их сравнение с уролитиазом

Аннотация

Background. The number of patients with preurolithiasis (PUL) is many times higher than the number of patients with stones. So in the Samarkand region the frequency of urolithiasis (UL) was 1.9%. and the PUL - 21.7%, in the Khorezm (Pitnak) UL - 0.8%, and the PUL - 16.8%. The state of the diuretic and saluretic function of the kidney calcium PUL (CPUL) has not been studied. Information on the difference between the condition of patients with CPUL and calcium UL (CUL) will allow the development of methods for preventing the transition from CPUL to CUL. The aim is to study the diuretic and saluretic functions of the kidneys in CPUL pts and to conduct a comparative analysis with similar indicators of CUL. Material and methods. 383 patients with CPUL and 396 patients with CUL were examined. There were 233 men and 163 women among patients with CUL. Among the 383 patients with KPUL 213 were men and 170 were women. The average age was 39.95 + 12.66 years. Evaluation criteria: daily diuresis volume, urine reaction, daily urinary excretion of inhibitors (magnesium, citrate) and promoters of stone formation (calcium, oxalate, uric acid, inorganic phosphorus Pi), ion activity indices -AP [CaOx] and AP [CaPi]. Results. With a CPUL of 96.53%, diuresis is reduced as a result of an increase in the CR and a decrease in CF. Hypocitraturia in 96.92%, hyperoxaluria 92.94% and calciuria 73.68%, decrease in urine pH 72.66%. In 99.61% of cases multiple pathology of lithogenesis parameters is observed (two - 23.23%, three - 56.48% and four - 17.72%). This confirms the multifactorial nature of the etiopathogenetic mechanisms of stone formation. In the case of CPUL, the changes in AP [CaOx] AP [CaPi] are similar to CUL. Conclusion. Thus, the nature of disorders in CPUL is as complex as in CUL, in connection with which these patients (with CPUL) should have no less attention than CUL. In patients with CPUL. prophylactic treatment to prevent the transition to CUL should begin with the correction of citraturia, stimulation of diuresis, correction of hyperoxaluria, urine pH. and particular attention should be paid to the correction of uricuria.